Photopheresis for the treatment of cutaneous T-cell lymphoma

Since its introduction in 1987, photopheresis has provided an additional modality in the treatment of patients with CTCL; it should probably be considered as the first line of treatment for patients with the erythrodermic stage disease. It is clear that in the responders, significant improvement in the quality of life can be achieved. The toxicity is minimal. As compared with historical control groups, patients treated with photopheresis have a prolonged survival. Although the precise therapeutic mechanism is yet to be fully elucidated, substantial evidence implicates increased immunogenicity of class I associated peptides specific for the malignant cells. Additional issues to be resolved include the role of adjunctive therapy, cost effectiveness of this treatment modality, and applicability to nonerythrodermic stages of CTCL.